PROJECT ABSTRACT Colorectal cancer (CRC) is the second leading cause of cancer death in the United States. Unfortunately, there are significant CRC screening disparities that result in higher rates of CRC-related morbidity and mortality for minority and rural patient populations, particularly in the southern United States. The development of interventions that capitalize on advances in communication, informatics, and computer science have great promise for resolving theoretical and practical problems associated with CRC screening decision-making. The purpose of this proposal is to test the efficacy of a patient-centered, tailored message intervention delivered via virtual technology for increasing CRC screening within guidelines among racial/ethnic minority and rural patients. We hypothesize that exposure to a minimally tailored CRC screening intervention delivered via VHT will lead to improved cognitive processing of the intervention and increased adherence with initial and repeated annual FIT screening completion as compared to a fully tailored, text-only intervention. This hypothesis will be tested through two specific aims. In Specific Aim 1, we will conduct focus groups and think-aloud interviews stratified by geography, gender, and racial/ethnic background to expand and pilot test an intervention that uses a virtual human as a delivery mechanism for CRC screening information. In Specific Aim 2, patients (N = 3,000) will be recruited via primary care clinics and a secure, clinical data warehouse to complete a patient- randomized test of the efficacy of the intervention for promoting initial and repeat FIT testing. Dependent measures will be assessed via patient self-report and chart review. The proposed study will reduce health disparities and associated morbidity and mortality due to CRC via increasing screening among racial/ethnic minority and rural populations.